Displaying 127401-127410 of 1611142 results.
ID:
127401
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
197363
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
127402
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
197364
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
127403
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
197383
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
127404
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
197382
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
127405
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
805515
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
380
Qty Limit Days:
30
ID:
127406
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
603378
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
127407
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1190225
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
20
ID:
127408
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
580261
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
127409
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
836368
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
127410
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
1552004
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
30
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